Implication of late diagnosis for survival of patients with colorectal carcinoma

Abstract

Background/Aim. Colorectal cancer (CRC) is one of the most frequent diseases and early diagnosis has a potential role to improve survival. The aim of this study was to analyze influence of delay in diagnosis on survival in patients with colorectal cancer. Methods. A total of 119 patients with pathohystological diagnosis of CRC were included in the study. They were operated at our Department for Surgery from 2000 to 2002. They were divided into two groups according to the duration of symptoms: early operated patients - EOP (symptoms were presented for 3 months) and late operated patients - LOP (duration of symptoms was more than 3 months). Follow-up period was 5 year. Results. Weight loss, intermittent abdominal pain and anorexia were more frequent in LOP (p < 0.01). Young age, blood in stool, and tumor localized in rectum were dominant characteristics in EOP (p < 0.05). Overall delay in diagnosis was 2.19 ± 0.79 months in EOP and 11.37 ± 5.68 months in LOP. There was highly statistically significant difference between these two groups (p < 0.01). Overall survival was 44.75%. Five years survival was 65.9% in the group of EOP and 26.5% in the group of LOP (χ2 = 28.16, p < 0.01) Weight loss was dominant characteristics in the patients who did not survive five years (χ2 = 14.26, p < 0.01). A period of 2 months in delay in diagnosis is 'cut-off' value in prediction of death (sensitivity of 75.5% and specificity of 90.3%). Conclusion. A delay in diagnosis and stage of the disease are highly significant factors of patients with CRC survival. In everyday medical practice higher importance should be put on weight loss, intermittent abdominal pain, change in bowel habits, as well as on syderopenic anaemia.

Keywords

• colorectal neoplasms
• diagnosis
• prognosis
• survival analysis